Why Does My Baby Choke On A Bottle? Things You Shouldn’t Be Doing

It’s a heart-stopping moment!

When your baby is calmly drinking their bottle and suddenly starts to choke, time seems to stand still and run-away at the same time. Most parents freeze at this moment, not knowing what to do and hoping it passes soon. Others immediately jump into action and start to pat the baby on the back.

I personally had many scary moments like this as my little one suffered from terrible acid reflux. I know how helpless it feels and how many questions you are left with. Is my baby OK? Should I take him to the doctor? Why did this happen? How could I have prevented it or at least helped him?

The list never ends. So, in this article, we will discover why babies choke while bottle-feeding, how we can prevent or minimize it from happening, and what to do when it happens. 

What is choking?

Choking is the coughing spasm that happens when liquids or solids get into the windpipe. A baby chokes when their upper airway gets blocked, and it causes breathing difficulties. If the blockage isn’t removed quickly, it may lead to death, especially if an object or food is the culprit. Chocking on liquids is usually temporary, and besides the massive scare you get, it’s harmless.

In some cases, like bottle-propping, choking could quickly become a life-threatening emergency for your baby.

Why do babies choke while drinking a bottle?

Choking is a normal human function and can often happen and for a variety of reasons. With babies, their tiny bodies are still figuring out how to control and operate daily activities like eating, drinking, moving, etc.

Milk choking happens when your baby takes in more milk than their little mouths can handle, and they’re unable to swallow these large amounts sufficiently. The milk overflows into the airway causing your baby to choke.

Sometimes babies will choke for natural reasons, like a little spit-up. Other times, bottle-feeding chocking can be caused by things like:

  • Bottle-propping
  • Incorrect positioning
  • Incorrect teat size

Bottle propping and why it’s dangerous

Women in general, but especially moms, are famous for multi-tasking. Mothers have so many things to accomplish in a day and need to get creative to get around to it all. Sometimes, we try and cut corners to make things a little easier. In some cases, as with bottle-propping, it’s not the best idea!

Bottle propping is when you take a bottle and let it lean against a pillow, cushion, or any other object, so it’s supported at an angle, allowing milk to dribble from the teat or your baby to suck milk from it easily, to ‘feed themselves.’ No one is holding the baby or the bottle to feed them. Essentially, the baby is left feeding unsupervised.  It’s a very dangerous practice that can be deadly.

So, why is bottle-propping dangerous?

As mentioned before, a baby’s body is still learning how to function. Often the swallow reflexes are much slower than the speed of fluids building up in their mouths from the sucking action.

It is also possible that a teat may leak milk while in the propping position, even though the baby is not sucking. The baby could fall asleep before the bottle is empty and potentially breathe in the milk dripping out the teat instead of swallowing it.

Incorrect positioning while feeding your baby

Baby laying flat on his back while bottle feeding. This is not good as there's a higher chance of milk going down the wrong tube, causing him to choke.

When you position your baby to lay down flat on their backs, or even on their sides, it becomes more likely that the milk will go down the wrong tube. Young babies don’t have enough strength in their necks to lift their own heads. They will struggle to move away from flowing milk as gravity takes over.

Babies will struggle to escape from the flow of the milk and eventually start to breathe it in. If they can’t turn their heads away or dislodge the bottle from their mouths, they will choke and possibly die if they are not helped soon enough.

Incorrect teat size for your baby’s bottle

A teat used on a bottle is designed to mimic a mother’s nipple, which is self-regulating. Without proper latching and sucking motion, a baby will have difficulty getting enough breastmilk. A teat should work on the same principle, and they usually do but only when they are new.

Once teats have been used a few times, they soften up and begin developing a slow leak that will start with a drop of milk. The teat will tend to leak at a faster pace with increased use. The fuller the bottle, the quicker the leak, caused by gravity feed and pressure from the milk volume.

Teats are made for different aged infants and have an age-appropriate guide printed on the packaging. Remember, this is just a guide. As a mom, you should buy teats appropriate for your baby, and your judgment should be on your baby’s development and motor skill ability. Select a teat that dispenses just enough milk to work in synergy with your baby’s sucking motion.

Manufacturer standards may differ, so if you change brands, keep this in mind. The flow rate of a teat is important as getting too little or too much milk may cause feeding problems. If the teat does not release enough milk, your baby will tire and fall asleep without completing the feed. Alternatively, a teat with too fast a flow can result in overfeeding.

Teats come in different shapes and sizes for a reason. It promotes proper latching on the teat and reduces taking in and swallowing air in the process. Some babies will only feed with specific teats because they experience the most comfort and ease of use.

How to prevent choking

Mom bottle-feeding her baby in a safe way to prevent choking

No matter what the circumstances are, avoid feeding your baby by propping up the bottle. Do not let your baby drink from a bottle unattended.

Use a teat that provides your baby with the right amount of milk, and check the teat for leaks before use. When feeding, hold your baby so that their head is at a slightly raised angle.

Do not force the teat into your baby’s mouth. Rest the top of the teat on your baby’s lips and allow them to respond by opening their mouth before you gently place the teat in their mouth.

If your baby begins to choke or gag, immediately remove the bottle from their mouth and raise them up to your shoulder. You can pat your baby softly on their back more as a comforting sign to calm them down.

When your baby stops sucking on the teat, and you can see milk leaking from their mouth, remove the teat and give them time to swallow what milk remains in their mouth. If you leave the teat in your baby’s mouth, it may lead to a choking episode.

Most babies will throw up a little bit of milk after a feed caused by reflux or a natural burp. To avoid the risk of choking when this happens, it’s best to keep your baby in an upright position. This is a general position used when burping your baby. You will normally drape a cloth over your shoulder to catch any throw-up. I’m sure all moms have experienced this.

Arrange your baby’s crib right next to you on your side of the bed so you can be close by to monitor your little one. This is standard practice for at least the first 6 months or a little longer. You will know when it’s time to move your little one to their own room but be sure to invest in a good quality baby monitor.

I personally wouldn’t recommend rushing the transition, not until you are happy that your little one sleeps through the night and has adjusted to the reality of permanence. Your little one must know that even if they can’t see you, you will always be close by.

What to do when your baby chokes

If your baby is choking, you should start doing the Heimlich maneuver immediately.

When people are in a state of panic, they will do the strangest things or do the right things but in the wrong order. What should you do if your baby starts choking?

By following the right sequence of actions, you could save your little one from trauma, health complications from lack of oxygen, or even death. Calling an ambulance or even going out to get help will take time, and this is a luxury not packaged in the immediate response drill. As a mother or caregiver, you should know exactly what to do when faced with a choking incident.

Time is critical when dealing with a choking infant. Don’t try and remove the choking hazard with your fingers, as you may end up pushing it deeper into the airway. Also, do not attempt the Heimlich maneuver as the abdominal thrusts may apply too much sudden pressure on vital organs and will harm rather than help your baby.

Call Emergency services to help and instruct you on exactly what to do to help your baby. If this is not possible, then follow this simple guide:

  1. Hold your baby tummy down on your forearm and use your hand to keep their mouth open.
  2. With the back of your fist, hit your baby firmly but not too hard between the shoulder blades toward the middle of the back.
  3. Hit five times, then turn your baby over and perform 5 CPR pumps but slower and sharper.
  4. Repeat the back thumping exercise and CPR pumps until the object is dislodged or help arrives.

The CPR pumps help maintain blood circulation feeding the body, especially the brain, with the much-needed oxygen still in the blood.

What to do if a baby is choking on fluids

You will perform the same maneuver as above. It is crucial to keep your baby at a slight incline with their head lower than their body, so gravity can also help to flush the milk from the airway.

Frequently Asked Questions

Is bottle propping really that dangerous?

Yes, it is! I know many moms prop bottles up when feeding their babies in a pram and watch until the little one falls asleep. This is wrong, and although it appears to work, you are placing your baby at risk.

A choking baby cannot make any sounds, and a sleeping baby doesn’t make sounds either, so it is easy to believe your baby is sleeping when, in fact, they are choking.

How do I know if the hole in a teat is too big?

You will notice the milk flow when you test the teat before use, but if you don’t, telltale signs are your baby will gag from the beginning of a feed. There will also be an overflow of milk from your baby’s mouth, and your baby might refuse to drink as a result.

How long do teats last?

Teats take a hammering from grinding gums and new teeth as they cut through the gums and stress from sucking so they don’t last too long.

It is recommended to change teats at least every two months, but circumstances may call for a change monthly.

Can my baby die from choking on milk?

It is not very likely if you react the moment your baby begins choking, but if it goes unnoticed, then yes, the chances are good that the liquid-filled airway will not clear itself, and your baby will not be able to breathe.

Conclusion

Bottle-feeding babies come with their own set of limitations. There is no real autopilot, as is the case with breastfeeding. Mothers have to make sure the teat on the bottle is comfortable for the baby.

The amount of milk released from the teat should complement your baby’s feeding style. Teats come in three different types; slow, medium, and high flow rates. It’s always best to start with a slow flow teat and move up as the need presents itself.

Choking is a real-time risk that can occur at any time. To reduce the risk, it is best to follow a hands-on feeding regiment where you are in control of your baby’s bottle at all times as a mom. Don’t get complacent and resort to propping up your baby’s bottle during feeds.

Lastly, learn what to do if your baby starts choking and always have your phone handy if you need to call for help. Getting advice from your pediatrician on dealing with a choking incident will help a great deal in giving you confidence. This will allow you to follow through with the right actions if you are ever faced with this situation.

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